Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Supradeep Shree Venkata Madduri

Individual provider Urology Physician · NPI 1467040501

Supradeep Shree Venkata Madduri is an Urology Physician in Jacksonville, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2021

Practice location Address checks out

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone: (904) 953-2000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 46196 (FL)

Record details

NPI number1467040501
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 5, 2021
Last updated in NPPESAugust 9, 2026
Certification dateAugust 9, 2026

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